Effect of early hypoglycaemia on hospitalization outcomes in patients undergoing coronary artery bypass grafting

Abstract

Objective: To investigate the effect of early postoperative hypoglycaemia on hospitalization outcomes including major cardiovascular complications and in-hospital mortality among patients undergoing coronary artery bypass grafting (CABG).

Methods: Data from an observational study of 9583 patients in the intensive care unit (ICU) who underwent CABG were analyzed. Hypoglycaemia was defined as a nadir blood glucose level <70 mg/dL (3.9 mmol/L). One-to-one propensity score matching (PSM) was used to identify 251-balanced pairs of patients to compare outcomes.

Results: A total of 306 (3.2%) patients experienced hypoglycaemia, of whom, 133 had diabetes, 173 hadn't diabetes. Patients who were hypoglycaemia had higher incidences of compositeoutcomes than those without hypoglycaemia (12.1% versus 6.0%, P < 0.0001). Postoperative length of ICU stay was longer in patients with hypoglycaemia [2.8 (0.8-21.0) versus 2.0 (0.25-36.0) days, P < 0.0001]. After PSM, the compositeoutcomes and length of ICU stay remained significantly increased for the patients with hypoglycaemia [compositeoutcomes: odd ratio (OR) 2.78, 95% CI, 1.30-5.88, P = 0.01; length of ICU stay: OR 1.60, 95% CI, 1.14-2.26, P = 0.007].

Conclusion: Postoperative hypoglycaemia was an independent associated factor of adverse composite outcomes and a lengthened ICU stay after CABG. Hypoglycaemia should be avoided for both postoperative patients with and without diabetes.

Keywords: Composite outcomes; Coronary artery bypass grafting; In-hospital mortality; Length of ICU stay; Postoperative hypoglycaemia.